Heart disease and cancer are the leading causes of death in the United States. Smoking is a shared risk factor for both lung cancer and cardiovascular disease, and individuals with lung cancer who also have pre-existing cardiovascular conditions face an increased mortality risk. Some treatments for lung cancer, such as radiation therapy, may further elevate the risk of developing heart disease in these patients. A new study has found that several cardiovascular risk factors, including advanced age and a history of smoking, are common among lung cancer patients at the time of diagnosis and contribute to their risk of future heart disease. This underscores the need for comprehensive assessments of this vulnerable group to enhance survival outcomes and the overall quality of care for cancer patients.

In the study, researchers at the University of South Alabama (Mobile, AL, USA) examined 276 lung cancer patients at a cancer center for existing atherosclerosis using staging computed tomography (CT) scans. Atherosclerosis occurs when plaque accumulates in the arteries, potentially obstructing blood flow and leading to cardiovascular complications. The study also collected data on systolic blood pressure, diastolic blood pressure, pulse pressure, body mass index, age, sex, race, smoking history, and lung cancer type. Each patient underwent imaging as part of the evaluation and staging of their lung cancer, which included chest CT scans. The results showed that 77.9% of the participants had detectable atherosclerosis on their CT scans. Furthermore, these CT scans were also able to detect atherosclerosis in the coronary arteries through calcification in the blood vessels.

The data revealed that 47.8% of patients had a systolic blood pressure of 130 mmHg or higher, and 38% had a diastolic blood pressure of 80 mmHg or higher. Systolic blood pressure, the top number in a blood pressure reading, reflects the pressure in the arteries when the heart beats, while diastolic blood pressure, the lower number, indicates pressure in the arteries between heartbeats. Normal blood pressure should be under 120/80 mmHg. The study also found that 27.2% of participants were obese, and 88.8% were either current or former tobacco users. Smoking was identified as the most prominent cardiovascular risk factor in this group, followed by advancing age, hypertension, and obesity. While the study did not have sufficient data to assess the effects of high cholesterol or diabetes adequately, the researchers noted that these risk factors should also be considered due to their established link with cardiovascular disease. A similar analysis was conducted using CT scans to assess atherosclerosis in gynecological cancer patients starting treatment. The results showed that nearly one-third of these patients also had atherosclerosis, indicating a high prevalence of heart disease. The cardiovascular disease risk factors identified in this study are largely modifiable, suggesting potential areas for intervention.

“This study suggests it may be reasonable to consider concurrent coronary calcium scoring on imaging obtained for lung cancer staging or screening to aid in identification of atherosclerosis and earlier intervention such as lifestyle, diet and cardiac risk factor modification education,” said Christopher Malozzi, DO, lead author of the study and director of cardio-oncology services at the University of South Alabama Frederick P. Whiddon College of Medicine. “The use of imaging already available may also reduce the need for additional testing in these patients and cut down overall health care costs.” 

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